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Global Standards for the initial education of professional nurses and midwives (WHO/HRH/HPN/08.6)

This publication was produced by the Department of Human Resources for Health, World HealthOrganization.

This publication is available on the Internet at: http://www.who.int/hrh/nursing_midwifery/en/

Copies may be requested from: World Health Organization, Department of Human Resources forHealth, CH-1211 Geneva 27, Switzerland

World Health Organization 2009

All rights reserved. Publications of the World Health Organization can be obtained from WHO Press,World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 3264;fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translateWHO publications whether for sale or for noncommercial distribution should be addressed to WHOPress, at the above address (fax: +41 22 791 4806; email: [email protected]).

The designations employed and the presentation of the material in this publication do not imply theexpression of any opinion whatsoever on the part of the World Health Organization concerning thelegal status of any country, territory, city or area or of its authorities, or concerning the delimitation ofits frontiers or boundaries. Dotted lines on maps represent approximate border lines for which theremay not yet be full agreement.

The mention of specic companies or of certain manufacturers products does not imply that theyare endorsed or recommended by the World Health Organization in preference to others of a similarnature that are not mentioned. Errors and omissions excepted, the names of proprietary products aredistinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to verify the informationcontained in this publication. However, the published material is being distributed without warrantyof any kind, either expressed or implied. The responsibility for the interpretation and use of thematerial lies with the reader. In no event shall the World Health Organization be liable for damagesarising from its use.

This publication contains the collective views of an international group of experts and does notnecessarily represent the decisions or the stated policy of the World Health Organization.

Edited by: Elizabeth Girardet, Freelance Editor, Geneva, Switzerland.

Design & layout by: www.sbgraphic.ch (cover illustration Eric Scheurer)


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3

Contents

Acknowledgements 4

Part one 7

Background 8

Goal of the global standards 10

Intended use of standards 12

The context 14

Process and methodology 16

Part two 18

Standards for nursing and midwifery initial education 19

Principles 19

1.0 Programme graduates 20

2.0 Programme development/revision 22

3.0 Programme curriculum 24

4.0 Faculty 26

5.0 Programme admission 28

Part three 30

References 31

Annex: List of respondents 32

Glossary 35


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Global standards for the initial education of professional nurses and midwives4

Acknowledgements

The World Health Organization (WHO) gratefully acknowledges the ex-

pertise, time and contributions of all those who engaged in the develop-

ment of these global standards, enriching the procedure with their collec-

tive wisdom, intellectual input and the shared experience of their diverse

organizations.

WHO is particularly grateful to the members of the Task Force on Global

Standards in Nursing and Midwifery Education who contributed their exper-

tise and resources over countless hours and worked with vision and com-

mitment to bring this initiative to completion: Dr Fariba Al-Darazi (WHO

Regional Oce for the Eastern Mediterranean), Dr Sawsan Al-Majali (Nurs-

ing Programme, Dar Al-Hekma College), Ms Nancy Dickenson-Hazard

(Sigma Theta Tau International), Dr Valerie Fleming (Glasgow Caledo-

nian University, WHO Collaborating Centre for Nursing and Midwifery),

Dr Karen Morin (University of Wisconsin, Milwaukee),and Dr Jean Yan

(World Health Organization).

WHO also extends sincere appreciation to the individuals and organizations

that participated in the following meetings.

Developing Global Standards for Initial Nursing and Midwifery Educa-

tion, Bangkok, Thailand, December 2006:

Dr Sawsan Al-Majali (The Global Advisory Group for Nursing and Mid-wifery Advisers for Nursing and Midwifery), Dr Jean E. Bartels (Ameri-

can Association of Colleges of Nursing), Mr David C. Benton (International

Council of Nurses), Dr John Daly (Council of Deans of Nursing and Mid-

wifery, Australia and New Zealand), Ms Nancy Dickenson-Hazard (Sigma

Theta Tau International), Dr Majeda Mohammed El-Bana (Scientic Asso-

ciation of Arab Nursing Faculties), Dr Valerie Fleming (WHO Collaborat-

ing Centre for Nursing and Midwifery Development, Glasgow Caledonian

University), Dr Kathleen Fritsch (WHO Regional Oce for Western Pa-

cic), Ms Andrea E. Higham (Johnson and Johnson), Ms Anne Hyre (Johns

Hopkins Program for International Education in Gynecology and Obstet-

rics), Ms Lennie Adeline Kamwendo (Association of Malawian Midwives),

Dr Shak Ketean (International Network for Doctoral Education in Nurs-

ing), Dr Siriporn Khampalikit (Thammasat University, Faculty of Nursing),


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5Acknowledgements

Dr Wipada Kunaviktikul (WHO Collaborating Centre for Nursing and Mid-

wifery, Chiang Mai University), Dr Lynnette Leeseberg Stamler (Canadian

Association of Schools of Nursing), Mrs Mara Paz Mompart Garca (Asoci-

acin Latino Americana de Escuelas y Facultades de Enfermera), Dr Karen

Morin (Sigma Theta Tau International), Dr Barbara L. Nichols (Commission

on Graduates of Foreign Nursing Schools), Dr Kobkul Phancharoenworakul

(WHO Collaborating Centre for Nursing and Midwifery Development, Fac-ulty of Nursing, Mahidol University), Dr Rutja Phuphaibul (WHO Collabo-

rating Centre for Nursing and Midwifery Development, Faculty of Nursing,

Mahidol University), Dr Richard W. Redman (International Network for

Doctoral Education in Nursing), Dr Darunee Rujkorakarn (Chair of the

Consortium of Deans and Heads of Nursing Educational Institutes, Chair of

the Accreditation Committee for Nursing Educational Institutes Thailand),

Dr Ellen Rukholm (Canadian Association of Schools of Nursing), Dr Maria

Teresita Sy-Sinda (Silliman University, College of Nursing and Allied Health

Science), Dr Nenita P. Tayko (Foundation University, College of Nursing,

Philippines), Dr Josena A. Tuazon (WHO Collaborating Centre for Lead-

ership in Nursing Development, University of the Philippines, Manila),

Dr Kim Usher (Council of Deans of Nursing and Midwifery, Australia and

New Zealand),and Dr Jean Yan (World Health Organization, Geneva).

Task Force Meeting on the Global Standards for Initial Nursing and Mid-

wifery Education, Glasgow, Scotland, November 2007:

Mrs Fadwa Aara (International Council of Nurses), Dr Sawsan Al-Majali

(Global Advisory Group for Nursing and Midwifery Advisers for Nurs-ing and Midwifery), Ms Nancy Dickenson-Hazard (Sigma Theta Tau In-

ternational), Dr Valerie Fleming (Global Network of WHO Collaboarting

Centres on Nursing and Midwifery Development), Dr Karen Morin (Sigma

Theta Tau International), Ms Nester Moyo (International Confederation

of Midwives), Dr Bente Sivertsen (WHO Regional Oce for Europe), and

Dr Jean Yan (World Health Organization, Geneva).

WHO also wishes to acknowledge the contributions of:

Mrs Margaret Phiri, Regional Adviser for Nursing and Midwifery (AFRO),

Dr Prakin Suchaxaya, Regional Adviser for Nursing and Midwifery (SEARO),

Dr Silvina Malvarez de Carlino, Regional Adviser on Nursing and Allied

Health Human Resources (EMRO)


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6 Global standards for the initial education of professional nurses and midwives

WHO is grateful for the valuable resource material provided by the World

Federation of Medication Education in its publication: Basic Medical Educa-

tion: WFME Global Standards for Quality Improvement (University of Co-

penhagen, Denmark, 2003).

Furthermore, WHO gratefully acknowledges the generosity of the organiza-

tions that provided external funding support: the American Association ofColleges of Nursing, the Campaign for Nursing, and the Council of Deans

and Heads of University Faculties for Nursing and Allied Health Professions

in the United Kingdom.

In conclusion, WHO acknowledges and appreciates the contribution of all

the individuals and institutions that reviewed the standards and provided

feedback.


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Part one

Global standardsfor the initial educationof professional nursesand midwives


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Background

An estimated 35

million nurses and

midwives make upthe greater part of

the global health-

care workforce.

An estimated 35 million nurses and midwives make up the greater part of

the global health-care workforce (1). Nurses and midwives make a substan-

tial contribution to health-delivery systems in primary care, acute care and

community care settings. However, despite this, they are seldom involved

in policy development for human resources for health or in high-level stra-

tegic decision-making. In many countries this may be due to the perceived

status of nurses and midwives; it could also be a result of the general levelof education of the profession (2).

In 2001 the World Health Assembly (WHA) supported the call to strengthen

the nursing and midwifery professions by passing resolution WHA54.12,

validating WHOs commitment to the scaling-up of the

health professions. This resolution specically estab-

lishes the imperatives: a) for Member States to give

urgent attention to ways of improving nursing and

midwifery in their respective countries, and b) for the

Director-General to prepare an action plan, with inbuilt

evaluation procedures, for strengthening nursing and

midwifery services (3). The Strategic Directions for

Strengthening Nursing and Midwifery Services 2002

2008 (4), served as a blueprint for the subsequent

implementation of the resolution. A further resolution,

WHA59.23, (5)stresses the development of global standards for initial educa-

tion as a priority activity in strengthening nursing and midwifery services in

order to achieve the Millennium Development Goals (MDGs) for health (6).

The need for global standards has arisen for several reasons the increas-

ing complexities in health-care provision, the increasing number of health

professionals at dierent levels, and the need to assure more equitable

access to health care. The great variation in the levels ofinitial education

(see Glossary)for professional nurses and midwives around the world can

no longer be neglected. Many countries still consider initial education pro-

grammes at secondary school level to be sucient, while some countries

specify university-level education as the minimum point of entry to the

health professions for nurses and midwives (in practice, university-level

education is more frequently specied for nursing than for midwifery).

Despite slow beginnings, the move to raise the qualication requirements

of initial education programmes for professional nurses and, in some cases


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9Background

It will be the task

of policy-makers

in each country

to determine

timeframes for the

implementationof the global

standards.

for midwives, to a higher-education level(see Glossary) appears to be gain-

ing impetus. The rst known university-based education programme for

nurses was implemented in New Zealand as long ago as the 1920s (7). Sev-

eral countries around the world subsequently moved some of their nursing

education programmes to universities, although it was not until the 1950s

that university-level programmes became commonplace in North America.

The move spread in the 1980s to some Western Pacic countries and partsof Europe. In Egypt, the Alexandria University opened a faculty for nursing

education in 1954.

The notion of university education itself still remains problematic and there

are many disparities in the programmes currently being oered in dierent

parts of the world. For instance, the length of the courses oered varies from

two to ve years; some countries oer nursing programmes but not midwifery

programmes in the higher education sector; some countries oer comprehen-

sive programmes that combine nursing and midwifery while others see the

two as separate professions and maintain separate eduction programmes for

each; some countries oer midwifery only as an option

for qualied nurses, while others recognize midwifery

as a profession distinct from nursing.

In developing the global standards for the initial edu-

cation of professional nurses and midwives, close at-

tention has been paid to the above dierences. Some

countries already meet the global standards for initial

education. Readers are urged, however, to note thatmeeting the global standards is a goal for the future

for many countries a goal to be reached within a

timeframe determined by national factors such as the

countrys health plans.

It will be the task of policy-makers in each country to determine timeframes

for the implementation of the global standards. Some countries may adopt

a stepwise approach; they may choose to rst implement programmes to

meet urgent country needs and build on them subsequently.

This document describes the context and process followed in developing the

global standards, and presents the standards with their respective goals.


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Initial nursing or midwifery education aims to prepare individuals to ll

a role in the professional workforce where they will be called upon to

strengthen health systems to meet population needs and protect the pub-

lic. High quality education programmes that meet a global standard are

therefore imperative.

The global standards for initial nursing and midwifery education identifyessential components of education. Implementation of the standards will

facilitate progress towards the highest level of education attainable in a

country or region, assure equitable and appropriate placement of nurses

and midwives in health-care roles and, potentially, simplify recruitment

practices throughout the world (8, 9).

The future of nursing and midwifery education lies in good preparation at

the professional, rst-degree level(see Glossary). This level of education is

being successfully provided in many countries (10)and research has dem-

onstrated that a more highly educated nursing workforce not only improves

patient safety and quality of care but saves lives (1).

There are, however, particular problems that may limit immediate imple-

mentation of the global standards. As mentioned above, it is recognized

that the provision of university-level education in many countries is a goal

for the future. Working globally towards university-level education for pro-

fessional nurses and midwives will require country-specic strategies that

The goal of the global standards is to establish educational

criteria and assure outcomes that:

a) are based on evidence and competency;

b) promote the progressive nature of education and lifelong

learning; and

c) ensure the employment of practitioners who are compe-

tent and who, by providing quality care, promote positive

health outcomes in the populations they serve.

Goal of the global standards


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11Goal of the global standards

take into account national and/or regional factors such as dierent entry

points for education, cultural beliefs and norms, prior learning, experience

and progression options.

The global standards for initial education provide an opportunity for coun-

tries to invest in building the capacity required to raise the standard of edu-

cation of existing nursing and midwifery programmes to university level,thereby promoting continuous learning(see Glossary) and assuring profes-

sional advancement that is in line with worldwide education trends.


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Intended use of standards

The global standards for the initial education of professional nurses and

midwives are intended to serve as a benchmark for moving education and

learning systems forward to produce a common competency-based out-

come in an age of increasing globalization. It is anticipated that the global

standards will be used in the nursing and midwifery professions, as well

as in other health-related professions and by policy-makers and decision-

makers in ministries of health and education, the public, education services,regulatory bodies and various other organizations.

These standards represent the views of nursing and midwifery constitu-

encies throughout the world. Regular revisions, in partnership with other

international professional organizations, are anticipated.


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13Intended use of standards

1 Competencies such as those published by the International Confederation of Midwives and theInternational Council of Nurses.

The global standards have potential uses in various activities,

such as in:

1) establishing a global approach to the provision of evidence-

based educational programmes;

2) applying established competencies1 to provide a guide for

curriculum development;3) stimulating the creation of nursing or midwifery schools and

programmes that meet national, regional and societal needs

and expectations;

4) establishing benchmarks for continuous quality

improvement and the progression of education in nursing

and midwifery.

The global standards may furthermore:

5) act as a catalyst in advocating for education change, reformand quality improvement;

6) serve as leverage in building capacity for adequate numbers

of nurses and midwives and a competent, high quality

nursing and midwifery workforce for strengthening health

systems;

7) serve as a basis for the development of global standards for

advanced nursing and/or midwifery education.


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Each country

needs to have anadequate and sus-

tainable source of

health profession-

als, trained within

the context of

current and future

issues in patient

safety and qualityof care.

Each country needs to have an adequate and sustainable source of health pro-

fessionals, trained within the context of current and future issues in patient

safety and quality of care, and trends in shortages of nurses and midwives and

workforce migration (11). In implementing strategies to meet this goal, there

is a need: a) to alter the skill mix of the future workforce to include a greater

proportion of nurses and midwives who have been educated to degree level

or higher, and b) to use denitions and competencies, such as those issued byinternational organizations representing nursing and/or midwifery.

Nursing encompasses autonomous and collaborative care of individuals of all

ages, families, groups and communities, sick or well and in all settings. Nursing

includes the promotion of health, prevention of illness, and the care of ill, disa-

bled and dying people. Advocacy, promotion of a safe

environment, research, participation in shaping health

policy and in patient and health systems management,

and education are also key nursing roles. (12)

The international denition of the midwife states that:

The midwife is recognized as a responsible and ac-

countable professional who works in partnership with

women to give the necessary support, care and advice

during pregnancy, labour and the postpartum period,

to conduct births on the midwifes own responsibility

and to provide care for the newborn and the infant.

This care includes preventive measures, the promo-

tion of normal birth, the detection of complicationsin mother and child, the accessing of medical care or

other appropriate assistance and the carrying out of

emergency measures. (13)

Data synthesis from the background research step one of the standards

development procedure (described below) revealed that both nursing and

midwifery are gradually becoming more attractive career choices globally.

There are considerable dierences in the entry levels of these professions

and there is a general desire to raise the requirement for minimum entry

to university-level education, even though: a) the majority of existing pro-

grammes around the world do not currently specify this, and b) the insuf-

cient number of teaching sta in nursing and midwifery schools poses a

major challenge to achieving this goal.

The context


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15The context

While nursing and midwifery are unique health-care professions, the desire

to build the workforce capacity with competent practitioners is a common

goal that is reected in the WHO strategic directions for nursing and mid-

wifery (4). In the context of meeting this goal, and based on the knowledge

and expertise of education and practice leaders in nursing and midwifery,

ve key areas for global standards have been identied:

programme graduates,

programme development and revision,

programme curriculum,

academic faculty and sta,

programme admission.

The above key areas and their characteristics reect the recommended

components of competency-based education programmes and systems

(11). Individual schools, countries and/or regions are responsible for ar-

ticulating and implementing specic strategies and appropriate success

indicators according to their respective needs and situations.


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Process and methodology

The development of global standards for the initial education of nurses

and midwives has taken place over a three-year period. The Stakeholders

Meeting on the Contribution of Nursing and Midwifery to the Millennium

Development Goals (MDGs), convened by WHO in May 2005, established

specic strategic directions for the development of the standards. Subse-

quently in late 2005, a planning group led by the World Health Organiza-

tion and Sigma Theta Tau International, an international honour society ofnursing, was established to oversee the initial planning and implementation

of the standards. In March 2006, a nursing education scholar undertook a

review of existing standards and compiled a background synthesis docu-

ment. Throughout 2006 and 2007 additional methods were designed and

implemented including a literature review and analysis, consensus-build-

ing through a nominal group process, an expert analysis, and a feedback

analysis of public comments and data synthesis.


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17Process and methodology

Step 1: Gathering evidence and data. A thorough selection of

existing education standards from around the world was

compiled as a background document, analysed, synthe-

sized and used in consensus building (2).

Step 2: Securing expert consensus. Nursing and midwifery ex-

perts were convened to dene the key areas and minimum

elements of initial education for nursing or midwifery (14).

Step 3: Collection and assimilation of public comments. Draft

standards were developed and widely disseminated to

nursing, midwifery and external stakeholders and others

for public comment (see Annex).

Step 4: Analysis and synthesis. Over 100 public responses

were analysed and synthesized by a group of experts.

The standards were then redrafted and submitted to the

regional nurse advisers for nal review.

Step 5: Document launch and global dissemination.

The successive steps of the procedure are outlined below.


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Part two

Global standardsfor the initial educationof professional nursesand midwives


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19Principles

Principles

While several factors are of paramount importance in the design, implemen-

tation and outcome of the global standards, the following three principles

underpin all the standards.

1) Established competencies provide a sound basis on which to build

curricula for initial education to meet health population needs.

2) The interaction between the nursing or midwifery student andthe client(see Glossary) is the primary focus of quality education

and care.

3) An inter-professional approach to education and practice is critical.

It is recommended that the global standards be piloted, frequently reviewed,

evaluated and revised on the basis of user feedback.


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1.1.1 Graduatesdemonstrateestablishedcompetenciesinnursingandmid-

wiferypractice.

1.1.2 Graduatesdemonstratesoundunderstandingofthedeterminantsof

health.

1.1.3 Graduatesofaninitialprogrammeinnursingormidwiferymeetregula-

torybodystandardsleadingtoprofessionallicensure/registrationasa

nurseoramidwife.

1.1.4 Graduatesareawardedaprofessionaldegree.

1.1.5 Graduatesareeligibleforentryintoadvancededucationprogrammes.

1.1.6 Nursingormidwiferyschoolsemploymethodstotracktheprofessionalsuccessandprogressionofeducationofeachgraduate.

1.1 Outcomes

Programme graduates1.0


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211.0 Programme graduates

1.2.1 Nursingormidwiferyschoolgraduateswillbeknowledgeablepractition-

erswhoadheretothecodeofethicsandstandardsoftheprofession.

1.2.2 Nursingormidwiferyschoolspreparegraduateswhodemonstrate:

useofevidenceinpractice,

culturalcompetence,

theabilitytopractiseinthehealth-caresystemsoftheirrespective

countriesandmeetpopulationneeds,

criticalandanalyticalthinking,

theabilitytomanageresourcesandpractisesafelyandeffectively,

theabilitytobeeffectiveclientadvocatesandprofessionalpartners

withotherdisciplinesinhealth-caredelivery,

communityserviceorientation, leadershipabilityandcontinualprofessionaldevelopment.

1.2 Programme graduate attributes


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2.1.1 Nursing ormidwifery schoolsdeneandmakepublictheirmission,

visionandobjectives.

2.1.2 Nursingormidwiferyschoolseducatetheirstudentsthroughthepro-

grammetomeetthehealth-careneedsoftheirsocieties.

2.1.3 Nursingormidwiferyschoolsclearlydenetheeducationalandclinical

outcomesoftheprogramme.

2.1.4 Nursingormidwiferyschoolsemploynursingormidwiferyfaculty(see

Glossary)withrelevantexpertiseinthesubjectmatterandtheabilityto

developandrevisetheirprogrammes.

2.1.5 Nursingormidwiferyschoolshaveinplaceanduseasystemofforma-

tiveandsummativeassessmentoftheprogrammeseducationalandclinicalobjectivesandoutcomes.

2.1.6 Nursingormidwiferyschoolsdeneroledescriptionsfortheoreticaland

clinicaleducatorsincluding,butnotlimitedto,faculty,clinicalsupervi-

sors,mentors,preceptorsandteachers.

2.1 Governance

Programme development / revision2.0

2.2 Accreditation

2.2.1 Nursingormidwiferyschoolsareanintegralpartofahighereducation

institutionthatmeetsinternalstandards,recognizedaccreditationand/

orgoverningbodyrequirements.

2.2.2 Nursingormidwiferyschoolshavecriteriainplacethatmeetaccredita-

tionstandardsforclinicalpracticecomponentsoftheirprogrammes,

academiccontentandthedemonstrationofprofessionaloutcomes.

2.2.3 Nursingormidwiferyschoolsandtheirprogrammesarerecognizedoraccreditedbycredible,relevantprofessionalandacademicbodiesand

re-accreditedasrequired.


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232.0 Programme development / revision

2.3.1 Nursingormidwiferyschoolshaveaccessible,currentandrelevantphys-

icalfacilitiesincluding,butnotlimitedto,classrooms,clinicalpractice

sites,informationandcommunicationstechnology,clinicalsimulation

laboratoriesandlibraries.

2.3.2 Nursingormidwiferyschoolshavea systemandpolicyinplacethat

ensuresthesafetyandwelfareofstudentsandfaculty.

2.3.3 Nursingormidwiferyschoolshaveprofessionalsupportpersonneland

humanresourcestomeetprogrammeandstudentdemand.

2.3.4 Nursingormidwifery schoolshave abudgetallocationandbudget

controlthatmeetsprogramme,facultyandstudentneeds.

2.3.5 Nursingormidwiferyschoolshaveasysteminplaceforstudent-supportservices.

2.3 Infrastructure

2.4 Partnerships

2.4.1 Nursingormidwiferyschoolsdemonstratesuccessfulpartnershipswith

theacademicinstitutionwheretheirprogrammeislocated,withother

disciplines,withclinicalpracticesites,withclinicalandprofessionalor-ganizationsandwithinternationalpartners.


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3.0 Programme curriculum

3.1 Curriculum design

3.1.1 Nursingormidwiferyschoolsdesigncurriculaanddeliverprogrammes

thattakeintoaccountworkforceplanningowsandnationalandinter-

nationalhealth-carepolicies.

3.1.2 Nursingormidwiferyschoolsplananddesigncurriculatomeetnationalandinternationaleducationcriteria,andprofessionalandregulatory

requirementsforpractice.

3.1.3 Nursingormidwiferyschoolsprovideclassroomandclinicallearning

thatdeliverstheknowledgeandskillsrequiredtomeettheneedsof

theirrespectivepopulations.

3.1.4 Nursingormidwiferyschoolsestablishanddemonstratebalancebe-

tweenthetheoryandpracticecomponentsofthecurriculum.

3.1.5 Nursingormidwiferyschoolsdemonstrateuseofrecognizedapproaches

toteachingandlearningintheirprogrammes,including,butnotlimited

to, adult education, self-directed learning, e-learning and clinical

simulation.

3.1.6 Nursingormidwiferyschoolsprovideclassroomandclinicallearning

basedonestablishedcompetenciesandgroundedinthemostcurrent,

reliableevidence.

3.1.7 Nursingormidwiferyschoolsenablethedevelopmentofclinicalreason-ing,problemsolvingandcriticalthinkingintheirprogrammes.

3.1.8 Nursingormidwiferyschoolsconductregularevaluationsofcurricula

andclinicallearning,andincludestudent,client,stakeholderandpart-

nerfeedback.

3.1.9 Nursingormidwiferyprogrammesofferopportunitiesformultidiscipli-

narycontentandlearningexperiences.


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253.0 Programme curriculum

3.2.1 Nursingormidwiferycurriculaprovidecorecontentthatwillenable

theirgraduatestomeettheestablishedcompetencies.

3.2.2 Nursingprogrammesprovidecorecontentinnursingtheory,practice,

interventionsandscopeofpractice.

3.2.3 Midwifery programmes provide core content in midwifery theory,

practice,interventionsandscopeofpracticeforstrengtheninghealth

systemsthroughtheprimaryhealth-careapproach.

3.2.4 Nursingormidwiferyprogrammesprovidesupervisedclinicallearningex-

periencesthatsupportnursingormidwiferytheoryindiversesettings.

3.2 Core curriculum

3.3 Curriculum partnerships

3.3.1 Nursingormidwiferyschoolsdeveloppartnershipswithotherhealth-

caredisciplines.

3.3.2 Nursing or midwifery schools use interprofessional teamwork ap-

proachesintheirclassroomsandclinicallearningexperiences.

3.3.3 Nursingormidwiferyschoolshaveaccessto,andarrangementsfor,the

clinicallearningsitesrequiredforprogrammedelivery.

3.4 Assessment of students

3.4.1 Nursing or midwifery schools assess student learning, knowledge

andskill developmentthroughout theirprogrammes,using reliable

evaluationmethodologies.

3.4.2 Nursingormidwiferyschoolsuseavarietyofmethodstoassessthesubjectmatterbeing studied including,butnot limited to, student

performance-basedassessmentandclient/stakeholderfeedback.

3.4.3 Nursingormidwiferyschoolshavestudentretentionsystemsinplace.


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Faculty4.0

4.1.1 Theheadofanursingormidwiferyprogrammeisanurseormidwife

whoholdsagraduatedegree,iseducatedandexperiencedinleader-

shipandadministration,anddemonstratesknowledgeasaneducator.

4.1.2 Thecoreacademicfacultyarenursesandmidwiveswhodemonstrateknowledgeaseducatorsandhaveaminimumofabachelorsdegree

preferablyagraduatedegreewithadvancedpreparationandclinical

competenceintheirspecialtyarea.

4.1.3 Otherhealthprofessionalswhoareguestlecturersinnursingormid-

wiferyprogrammesholdagraduatedegreeandpossessclinicaland

educationalexpertiseintheirspecialty.

4.1 Academic faculty

4.2 Clinical faculty

4.2.1 Clinicalfacultycomprisesnurses,midwivesandotherhealthprofession-

alswhoholdaminimumofauniversitydegreeandpossessclinicaland

educationalexpertiseintheirspecialtyarea.

4.2.2 Nursesandmidwiveswithclinicalexpertiseinthecontentareabeing

taughtaredesignatedtosuperviseandteachstudentsinthatclinical

practicearea.

4.2.3 Nursingormidwiferyschoolsformpartnershipstosecureavarietyof

qualiedpeopletobeclinicalsupervisorsandteachers.


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274.0 Faculty

4.3 Professional development of faculty

4.3.1 Nursingormidwiferyschoolshaveapolicyandsysteminplacethatvali-

datestheupdatedclinicalandeducationalexpertiseandcompetency

offaculty.

4.3.2 Nursingormidwifery schoolshave a system inplacethatprovidesfacultywithopportunitiesfordevelopmentinteaching,scholarship,

practiceandexternalprofessionalactivity.

4.3.3 Nursingormidwiferyschoolshaveasystemandpolicyinplaceand

providetimeandresourcesforcompetencydevelopmentforstaff.

4.3.4 Nursingormidwiferyschoolshavea policy and systemin place for

rewardandrecognitionofstaffinaccordancewiththerequirements

forpromotionandtenureoftheinstitution(seeGlossary).


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5.1.1 Nursingormidwiferyschoolshaveatransparentadmissionpolicythat

speciestheprocessofstudentselectionandtheminimumacceptance

criteria.

5.1.2 Nursingormidwiferyschoolshavea transparentnon-discriminatoryadmissionandselectionprocess.

5.1.3 Nursingormidwiferyschoolshavea systemandpolicyinplacethat

takes into account differententrypointsofstudents,recognitionof

theirpriorlearning,experienceandprogressionoptionstowardhigher

educationgoals.

5.1.4 Nursingormidwiferyschoolshaveentryrequirementsthatmeetna-

tionalcriteriaforhighereducationinstitutionsincluding,butnotlimited

to,completionofsecondaryeducation.

5.1 Admission policy and selection

Programme admission5.0


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295.0 Programme admission

5.2 Student type and intake

5.2.1 Nursingormidwiferyschoolsadmitstudentswithbackgroundsinbasic

scienceandmathematicswhodemonstrateskillsinthelanguageof

instructionandindealingwiththeclients.

5.2.2 Nursingormidwiferyschoolsadmitstudentswhohavetheabilitytomeettherequirementsoftheprogramme.

5.2.3 Nursingormidwiferyschoolsadmitstudentswhomeettheinstitutions

healthandanyotherrequirements,aswellasanynationalrequirements

forselection.

5.2.4 Nursingormidwiferyschoolsseekstudentswhodemonstratethewill

toserveinhealthandtheabilitytobeindependentlearners.


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Part three

ReferencesAnnex: List of respondentsGlossary


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31References

References

1. WHO. World Health Statistics, 2007. Geneva, World Health Organiza-tion, 2007.

2. Fleming V.Background paper on nurse and midwifery education standards inInterim Report of Proceedings Developing Global Standards for Initial Nurs-ing and Midwifery Education. Geneva, World Health Organization, 2006.

3. Resolution WHA54.12. Strengthening nursing and midwifery. In: Fifty-fourth World Health Assembly, 1422 May 2001. Resolutions and de-cisions. Geneva, World Health Organization, 2001.

4. WHO. Strategic Directions for Strengthening Nursing and MidwiferyServices, 20022008. Geneva, World Health Organization, 2002.

5. Resolution WHA59.23. Rapid scaling up of health workforce produc-tion. In: Fifty-ninth World Health Assembly, Geneva, 2227 May 2006.Resolutions and decisions. Geneva, World Health Organization, 2006.

6. United Nations. Millennium Development Goals for Health. New York,

United Nations, 2001.

7. Chick N. Nursing Research in New Zealand. Western Journal of NursingResearch, 9(3), 317334, 1987.

8. International Council of Nurses. Project Communiqu for the GlobalNursing Review Initiative: Policy Options & Solutions, 2005. (accessed 31 July 2006).

9. Commission on Graduates of Foreign Nursing Schools. Building GlobalAlliances III: The Impact of Global Nurse Migration on Health ServiceDelivery. Philadelphia, CGFNS, 2007.

10. Gonzlez J, Wagenaar R. The Tuning Project; Tuning educational struc-tures in Europe. Phase one nal report, 2003.

11. Resolution WHA59.27. Strengthening nursing and midwifery. In: Fifty-ninth World Health Assembly, Geneva, 2227 May 2006. Resolutionsand decisions. Geneva, World Health Organization, 2006.

12. International Council of Nurses. The Denition of Nursing. Geneva,2007 (page 1).

13. International Confederation of Midwives. Denition of the Midwife.The Hague, The Netherlands, 2005 (page 1).

14. WHO and Sigma Theta Tau International, Honor Society of Nursing. Inter-im Report of Proceedings: Developing Global Standards for Initial Nursingand Midwifery Education. Geneva, World Health Organization, 2006.

A bibliography of all other sources consulted is available upon request.


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Annex: List of respondents

The following institutions submitted responses during the development

procedure (step 3) when draft versions of the global standards were

circulated for public feedback and comment.

American Association of Colleges of Nursing, United States of America

American University of Beirut School of Nursing, Lebanon

Arkansas State Board of Nursing, United States of America

Asociacin de Escuelas Universitarias de Enfermera de la Repblica,Argentina

Nursing and Midwifery Council, Australia

California Board of Vocational Nursing and Psychiatric Technicians,United States of America

Association of Schools of Nursing, CanadaChief Nursing Ocers Directorate Department of Health,United Kingdom

Council of Deans and Heads of University Faculties for Nursing andHealth Professionals, United Kingdom

Danish Deans Council of Nursing

Department of Health, Philippines

Department of Health, Social Services and Public Safety, Northern Ireland

Escuela Nacional de Enfermera y Obstetricia, Mexico

European Nurse Directors Association, Finland

Faculdade de Enfermagem UFJF, Brazil

Facultad de Enfermera de la Universidad Nacional de Trujillo, Peru

Facultad de Enfermera, Universidad Catlica, Chile

Faculty of Nursing, National University of Colombia

Federal University of Bahia Nursing School, Brazil

Federation of International Nurse Educators, France

Forum for University Nursing Deans of South Africa

Global Alliance for Nursing Education and Scholarship, Canada


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33Annex: List of respondents

Grant MacEwan College, Canada

Hospital de Cruz Alta, Argentina

Institute of Health Care, University of Malta; Directorate of Nursing Services

Instituto Filosco e Teolgico Rainha Do Serto, Faculdade CatlicaRainha do Serto, Portugal

International Council of Nurses, SwitzerlandLambton College, Canada

Makassed University of Beirut, College of Nursing and Health Sciences,Lebanon

Malagasy Lutheran Nursing School, Madagascar

Max Stern Academic College of Emek Yezreel, Israel

Ministerio de Sanidad y Consumo, Spain

Ministry of Health and Social Development, Anguilla

Ministry of Health, Kosovo

Ministry of Health, National Institute of Public Health and Community,Canada

Ministry of Health, Nepal

Ministry of Health, Uganda

Ministry of Public Health, Republic of Cameroon

National Council of State Boards of Nursing, Nepal

Nurse Directors Association, United Kingdom

Nursing School So Paulo University, Brazil

Nursing Services, Ministry of Health, Cyprus

Oce of Nursing Services, First Nations and Inuit Health Branch,Health Canada

Oklahoma Baptist University, School of Nursing, United Statesof America

Order of Nurses in Lebanon

PAHO/WHO Collaborating Centre for Nursing and Mental Health,Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada

Peking Union Medical College, School of Nursing, Peoples Republicof China


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Royal College of Nursing, Australia

School of Nursing and Midwifery at the Royal College of Surgeonsin Ireland

Medical University of Bahrain

School of Nursing, The Hong Kong Polytechnic University

St Vincent and the Grenadines School of Nursing, Ministry of Health andthe Environment

Trinity Western University, Canada

Universidad de Tarapac, Arica, Chile

Universidade do Estado do Par, Brazil

Universidade Estadual de Campinas, State of Sao Paulo, Brazil

Universidade Federal do Cear, Brazil

University of Botswana

University of Cape Town, South Africa

University of Illinois at Chicago College of Nursing, WHO CollaboratingCentre for International Nursing Development in Primary Health Care, Brazil

University of Miami, United States of America

University of Oklahoma, United States of America

University of Puerto Rico Nurse-Midwifery Education Program,Puerto Rico

University of So Paulo College of Nursing, Brazil

University of Victoria, Australia

Walter Sisulu University, Eastern Cape, South Africa

Welsh Assembly Government, United Kingdom

WHO Collaborating Centre, Brazil

WHO Collaborating Centre, Columbia University, United States of America

WHO Collaborating Centre, Glasgow Caledonian University, Scotland

World Federation for Medical Education, Denmark

World Health Organization, Geneva

World Health Organization Representative, Khartoum, Sudan

Yerevan State Medical College Erebouni, Armenia


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35Glossary

Glossary

Accreditation The process by which a statutory body, an agency or anorganization scrutinizes, evaluates and recognizes an in-stitution, programme or curriculum as meeting the stand-ards necessary for providing an educational service.

Admission The process, based on dened criteria, by which astudent is allowed to enter the initial programme ofnursing or midwifery education.

Assessment An evaluation method and process.

Client A recipient of care. (Within the wide spectrum of nurs-ing and midwifery practices in the multiple-care set-tings covered by these standards, client rather thanalternatives such as user or patient has beenchosen as the most appropriate term.)

Clinical learning Part of the educational process that takes place in any

practice setting in a hospital or community.

Competency A broad composite statement, derived from nursingand midwifery practice, which describes a frameworkof skills reecting knowledge, attitudes, psychosocialand psychomotor elements.

Continuous Learning how to learn from lifes experiences. Bylearning viewing life (and work) as a learning programme, the

learner can continue to expand his/her capacity forliving and working.

Curriculum The totality of the education programme that is coher-ent in structure, processes and outcome and that linkstheory and practice in the professional education of anurse or of a midwife.

Experience Practical skill or practice derived from participation inevents as a basis for knowledge.

Expertise A high level of specialized knowledge, prociency orskill.

Faculty The academic or teaching sta in a college or univer-sity, or in a department of a college or university.

First degree University-level education, a baccalaureate or a bach-elors degree.

Governance The principles, policies and processes that allow forautonomous leadership and management of a school.


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Higher education Education provided by accredited institutions that oerprofessional degree-level programmes.

Infrastructure The basic physical and organizational structures need-ed for the operation of a school.

Initial education The planned educational programme that providesa broad and sound foundation for the safe autono-

mous practice of nursing or midwifery and a basis forcontinuing professional education. In simpler terms,initial education refers to the rst programme ofeducation required for a person to qualify as a profes-sional nurse or midwife.

Institution The larger educational unit (university, polytechnic,college, etc.) that incorporates a school or departmentof nursing/midwifery education.

Outcome The result or eect of completion of the programme.

Partnership The relationship between people or groups working

together for the same purpose.Professional degree The rst degree oered at university level.

Professional The process of maintaining or expanding knowledge

development or skills for a specic career trajectory.

Programme The complete course of study leading to qualicationas a nurse or as a midwife.

Recognition of Procedures (subject to quality control) whereby studentsprior learning are awarded credit towards completion of the initial

nursing or midwifery programme on the basis of

learning achieved prior to commencing the pro-gramme of study.

Registration A process by which the regulatory authority validatesthose who are bona de nurses or midwives that is,ocial recognition/documentation of successful com-pletion of the initial nursing and/or midwifery educa-tion programme.

School An organizational unit within an educational institu-tion such as a university or higher education system.

Stakeholder A party who aects, or can be aected by, the schoolsactions.

Standard Statement of a dened level of quality that articulatesthe expectations of initial nursing and midwifery pro-grammes.


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